Understanding Urinalyses presents to clinic for routine prenatal care and is feeling well. A urinalysis is positive for nitrites, leukocyte esterase and bacteria. Empiric antibiotics are prescribed. Is this APPROPRIATE? How did others respond? Reveal the answer Best Answer: Yes ✅ Explanation: The patient’s urinalysis is abnormal. In most cases, asymptomatic bacteriuria SHOULD NOT be …
Cystitis vs. Pyelonephritis presents to clinic with dysuria, flank pain & fever They are prescribed nitrofurantoin. Is this APPROPRIATE? How did others respond? Reveal the answer Best Answer: No 🚫 Explanation: Our patient has flank pain & fever, consistent with pyelonephritis. Nitrofurantoin is ONLY recommended in the treatment of cystitis. We should also consider …
Clostridioides difficile Prophylaxis A 70 year old with leukemia is admitted to the for febrile neutropenia. She was treated for C. difficile colitis last month. She is started on cefepime. She is not currently having diarrhea. Which is the BEST option? A. Test for C. difficileB. Start fidaxomicinC. Start oral vancomycin prophylaxis How did others respond? …
Coagulase-Negative Staphylococcus Bacteremia 3 patients are admitted to the hospital with coagulase-negative Staphylococcus spp. growing from blood cultures Patient 1 – 1 of 2 sets growing S. epidermidis with erythema at the catheter insertion site Patient 2 – 1 of 2 sets growing S. lugdunensis with NO symptoms Patient 3 – 1 of 2 sets …
Empiric Pip-Tazo in Intra-Abdominal Infections 2 patients are admitted & started on empiric piperacillin/tazobactam. Patient 1: with community-onset appendicitis Patient 2: with pancreatic cancer s/p recent Whipple with anastomotic leak & peritonitis In which patient is it REASONABLE to narrow antibiotics? How did others respond? Reveal the answer Best Answer: Patient 1 👨🏾 Explanation: 2017 …
The Clinically Non-Responding Patient has a history of heart failure and is admitted for respiratory distress. He is diagnosed with pneumonia After 2 days, his oxygen requirements are but he is afebrile. Which is the MOST APPROPRIATE next action? How did others respond? Reveal the answer Best Answer: Evaluate fluid status Explanation: 👴🏼 has a …
MRSA Nasal Screening After Vancomycin has pneumonia and is on day 5 of vancomycin. He has a history of MRSA No respiratory cultures have been collected. Should a MRSA swab be collected now? How did others respond? Reveal the answer Best Answer: No Explanation: The utility of MRSA 👃 swabs after anti-MRSA therapy is questionable …
Carbapenem-Resistant Acinetobacter baumannii is in the for pneumonia from carbapenem-resistant Acinetobacter baumannii (CRAB). She is started on minocycline. The team wants to use combination therapy Which is NOT an appropriate second agent? How did others respond? Reveal the answer Best Answer: Tigecycline Explanation: Sulbactam-containing antibiotics are the cornerstone of treating CRAB infections & should …
MRSA Nasal Screening in Diabetic Foot Infection is started on empiric vancomycin for a diabetic foot infection (DFI). His MRSA nasal screening is & he has NO history of MRSA Can vancomycin be STOPPED? How did others respond? Reveal the answer Best Answer: Yes, stop 🛑 Explanation: A small study in patients with DFIs and …
MRSA Nasal Screen in Pneumonia 2 patients are admitted to the for pneumonia and started on empiric antibiotics including vancomycin. A MRSA screen is collected for both patients. Patient 1: CAP with septic shock and MRSA screen Patient 2: non-severe CAP and MRSA screen Which patient is the WORSE candidate for de-escalation off vancomycin? …